Provider Demographics
NPI:1164853347
Name:ESQUIVEL, MELISA NICOLE
Entity Type:Individual
Prefix:MISS
First Name:MELISA
Middle Name:NICOLE
Last Name:ESQUIVEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4333 E VINEYARD AVE
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93036-1013
Mailing Address - Country:US
Mailing Address - Phone:805-981-5582
Mailing Address - Fax:
Practice Address - Street 1:4333 E VINEYARD AVE
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93036-1013
Practice Address - Country:US
Practice Address - Phone:805-981-5582
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-12
Last Update Date:2018-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF74493106H00000X
CALMFT98746106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist